Enrich Your Practice

Have a Little Fun!

ACA Marketplaces Expand Coverage for Chronically Ill

Enrollees have more chronic conditions, health care use versus other privately insured individuals

HealthDay News — The Affordable Care Act's Marketplaces covered a disproportionate share of non-elderly adults with high health care risks in the 2014 to 2015 time period, according to a study published in the April issue of Health Affairs.

Michael Karpman, from the Urban Institute in Washington, D.C., and colleagues assessed use of private non-group health insurance through federal and state-based Marketplaces among non-elderly adults with chronic conditions from July 2014 to December 2015.

Related Articles

The researchers found that over the study period, 45% of Marketplace enrollees aged 18 to 64 years were treated for chronic conditions, compared to 35% of non-Marketplace non-group enrollees and 38% of adults with employer-sponsored insurance. Compared to other privately insured adults, Marketplace enrollees also had higher service use, which likely contributed to rising premiums in the non-group market.

"As repeal of the ACA individual mandate takes effect in 2019, protecting coverage gains for adults with chronic conditions while stabilizing non-group premiums may depend on state-level efforts to spread the risk of Marketplace enrollees' health care costs across a balanced insurance pool," the authors write.